There is much suggestive evidence that work can be an important determinant of the course of severe psychiatric disorder. Many persons with severe psychiatric symptoms function effectively in a work situation. In fact, for such persons, work often provides a major source of support by distracting them from symptoms and contributing to self-esteem and social contacts. Such support could help in the recovery process; conversely, work stresses could contribute to relapse. In spite of the suggestive evidence for such roles of work in the course of severe psychopathology, there has been practically no systematic study of this possible relationship. Building on the previous two years' research, this project continues an empirical study of the relationships between work and the course of psychiatric disorder using three complementary methods: 1) Data on work and the course of disorder already collected in three earlier studies will be analyzed to focus on key questions related to work-course of disorder associations. These studies are the First Admission Study, the Vermont Longitudinal Project, and the first phase of this project. 2) Further development of a study of vocational rehabilitation practice will be carried out to tap the experience of vocational rehabilitiation counselors and attempt to systematize their understanding of work-psychopathology interaction. As part of this effort, selected vocational rehabilitation clients will be interviewed at intervals during and after their vocational rehabilitiation experience. 3) A second-generation intensive follow-up study of persons being discharged from psychiatric hospitalization will be carried out to improve the reliability of assessment instruments developed previously and revised on the basis of parts one and two, and to apply these instruments and the concepts they involve to a group of psychiatric patients not previously seen in this study, patients who have not worked in the year prior to hospitalization. With these methods, we hope to increase the understanding of the role of work in the course of severe psychiatric disorder and perhaps in this way also increase our understanding of the nature of these disorders themselves and the healing process. These findings should provide a bais for using work and perhaps various other aspects of social functioning more effectively for the treatment of severe psychiatric disorders.